What is the ADOS Test?


If you have a child with autism or young toddler showing signs you may have heard of ADOS testing. The autism diagnostic observation schedule – or the ADOS test – is a standardized diagnostic tool for testing for autism in children. The ADOS testing is a series of semi-structured tasks and structured tasks during which the examiner provides a number of chances for the subject to demonstrate communication and social skills. A person needs to be trained in order to conduct this professional autism test.

Today, I’m going to share with you about this test and what you can expect from it. There are no blood tests or brain scans to detect autism. Instead, there are lists of behaviors that practitioners look for to indicate that autism exists and should/can be diagnosed.

Some autism tests, such as looking for pointing, looking for pretend play and looking for language at age appropriate levels is incorporated into the ADOS test. It is the gold standard for diagnosis for many years now. Pediatric hospitals, school systems, even independent clinicians use ADOS testing for autism. So, here is what you can expect if a practitioner, a physician or a multidisciplinary team performs an ADOS test. 

What Is ADOS Testing?

I trained on the ADOS many years ago now. The process of completing an ADOS test is making direct observations under controlled circumstances using standardized scenarios. And then you take a look at how the child reacts in those controlled situations. 

One of the subtests that I remember testing is pretending to have a birthday party. You take the young child who is not talking at all or not talking much into a clinical area, a sanitized room, with no distractions or toys. Pull out a baby doll, Play-Doh, candle, and plate.

Then say that you are going to have a birthday party and follow a script to make the Play-Doh into a cake and put the candle on. Maybe you would see if the child puts a candle on. Then see if the child sings to the baby doll. See if the child puts the Play-Doh fake cake onto the plate. 

And so you score based on what happens in that scenario with the setup of the baby doll. If the child chews on the candle, that would be an abnormal behavior for that age. That would be a negative score towards the diagnosis of autism. It would indicate more autism was present. The more unusual behaviors such as licking the plate, trying to eat the Play-Doh would be behaviors that might indicate autism. 

On the other hand, if the child sings to the baby, puts the candle in the cake, claps after the song is done, those would add to a more positive score. Indicating that maybe it isn’t autism. This is just one of the setup scenarios within the ADOS that helps practitioners really see if a child is showing signs of autism. 

Assessment on Tablet with Everett Pointing

ADOS Test for Autism

There are different levels of the ADOS. The autism diagnostic observation schedule is mainly used for children. However, it can be used for older kids who you’re not sure have ADHD, speech delays, or obsessive compulsive behavior. There’s also a part of the ADOS that can be used for adults that have not been diagnosed yet.

In level one of the ADOS, the practitioner and the scenarios will be set up to look at how children respond to their name, if they’re pointing, and other language indicators. A lack of pointing is a red flag for children. They should begin pointing between 15 and 18 months of age. Pointing indicates interest and allows children to show something to a caregiver. Throughout the ADOS, while you’re working on the birthday party and different scenarios, you’ll also be watching for language, response to their name, and those sorts of things. Now, let us get to the specifics of what ADOS testing is.The ADOS test comprises four modules that are appropriate to children (as well as adults) of various language levels, from the non-verbal to conversational. The ADOS assessment of less verbal children falls in Modules 1 and 2. The ADOS 3 test is forthe assessment of more able and verbally fluent children. The test for autism also has a toddler module exclusively for children between 12-30 months old.Moreover, the select scores of the ADOS 2 test in the communication and social sections are combined in the diagnostic algorithm. This test for autism then sums up the repetitive behaviors and typecast interest pattern scores as a separate domain.Another related aspect that is no less important is what ADOS assessment for autism involves.The ADOS autism test typically takes place in a room with two clinicians. One of them engages the child and leads the activities while the other observes and records data. The ADOS assessment scoring generally takes between 45 minutes to 1 hour and ends with the clinicians meeting the parents to collect more information.
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If you’re worried about a child showing signs of autism, ask your pediatrician about getting a referral for an ADOS test. In the meantime, you can learn my step by step approach that works for young children with and without autism by first going to marybarbera.com/quiz and then watching my free workshop to help you get started on the right path today.

Assessment on Tablet with Everett Pointing

Transcript

The autism diagnostic observation schedule or the ADOS is a standardized diagnostic tool for testing for autism in children. Today, I’m going to be talking about this test and what to expect from it. Hi, I’m Dr. Mary Barbera, autism mom, Board Certified Behavior Analyst and bestselling author. Each week I provide you some of my ideas about turning autism around so if you haven’t subscribed to my YouTube channel, you can do that now. There is no blood test or brain scans to detect autism. Instead, there are lists of behaviors that practitioners look for to indicate that autism, uh, exists and should be diagnosed.

Um, some of those testings such as looking for pointing, looking for pretend play and looking for language at age appropriate levels is incorporated into the ADOS test, which is the gold standard for diagnosis for many years now. It’s used, uh, at pediatric hospitals, school systems, even independent clinicians for testing for autism. An ADOS test is not always used but today I want to just talk more about what you can expect if a practitioner, a physician or a multidisciplinary team does perform an ADOS test. The process of completing an ADOS test, which I’ve been trained on many years ago, is making direct observations under controlled circumstances, um, using standardized scenarios.

And then you take a look at how the child reacts in those controlled situations. So one of the subtests or the areas within ADOS  that I remember testing is you have a young child who is not talking at all or not talking, uh, much you would pull out in a standardized format in a, in a clinical area, so a sanitized room, if you will, um, with no distractions and their toys and everything. So you would pull out a baby doll, Play-Doh, a candle, plate, and you would say that you were going to have a birthday party. You would actually have to follow a script and make the Play-Doh into a cake and put the candle on, or maybe, you would see if the child puts a candle on.

You would see if the child sings to the baby doll. See if the, if the child puts the Play-Doh fake cake onto the plate. And so you would be scoring, um, what happens in that scenario with the setup of the baby doll.  But whether the child like chews on the candle, that would be a abnormal behavior for that age, you would, you would write that down and that would be a negative score towards the diagnosis of autism. Um, it would indicate more autism was present the more, um, unusual behaviors, licking, the plate, um, trying to eat the Play-Doh. Those would be all the behaviors that might indicate autism. And then on the other hand, if this child or another child sang to the baby, put the candle in, clapped after the song was done, those would be more positive that maybe it wasn’t autism, but this is just one of the setup scenarios within the ADOS that, uh, helps practitioners really see if a child is, um, showing signs of autism.

And it’s also good, it’s. It’s used for children, but there are different levels of the ADOS, and it can even be used for older kids who, um, you’re not sure if it’s ADHD or speech delay or, uh obsessive compulsive behavior. And there’s also a part of the ADOS that can be used for adults that have not been diagnosed yet.

So some of the things to look for in level one of the ADOS  in addition to the birthday party, the practitioner and the scenarios will be set up looking for, um, how children respond to their name. I did a video blog on this a while back, so you can check that out. Um, pointing is a, lack of pointing is a red flag for children.

Um, Between 15 and 18 months of age, if you’re not pointing a, to indicate interest and also to show a caregiver things, that is a red flag for autism. So throughout the ADOS, while you’re working on the birthday party and different scenarios, you’ll also be watching for pointing. You’ll also be watching for language, response to name and those sorts of things, which are the red flags for autism.

If you’re worried about a child showing signs of autism, ask your pediatrician about getting a referral for an ADOS test. And in the meantime, you can learn my step by step approach that works for young children with and without autism by first  going to marybarbera.com/quiz and take the quiz to help you get started on the right path today.

If you liked this video blog, I would love it if you would give me a thumbs up, leave a comment or share with others that might be interested and don’t forget to sign up and take the two minute quiz. It might really put you on the right path with, or without autism. And I’ll see you right here next week.

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